The questionable use of antihypertensive drugs in the Italian Liguria Region in the year 2003

In the last 30 years, countless studies have shown that antihypertensive drug therapy substantially reduces the risk of hypertension-related morbidity and mortality. However, the optimal choice for initial pharmacotherapy of hypertension is still controversial. The guidelines for hypertension management agree on many items but differ on a very important point: the drug of first choice. The Seventh Report of the US Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure and the World Health Organization/International Society of Hypertension Statement on Management of Hypertension recommend, for uncomplicated hypertension, a thiazide diuretic, either alone or combined with drugs from other classes, and delineate specific conditions that are compelling indications for the use of other antihypertensive drug classes. The European guidelines state that all available drug classes are suitable for the initiation and maintenance of treatment and underline that the benefits of the antihypertensive therapy are, for the most part, due to lowering of blood pressure per se and depend scarcely on the type of drug used.